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Relief of Cervicogenic Headaches after Single-Level and Multilevel Anterior Cervical Diskectomy: A 5-Year Post Hoc Analysis

STUDY DESIGN:  Prospective study. OBJECTIVE:  Because single-level disk arthroplasty or arthrodesis in the lower subaxial spine improves headaches after surgery, we studied whether this effect may be better appreciated after two-level arthroplasty. METHODS:  We performed an independent post hoc anal...

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Detalles Bibliográficos
Autores principales: Liu, Jonathan J., Cadena, Gilbert, Panchal, Ripul R., Schrot, Rudolph J., Kim, Kee D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2015
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993614/
https://www.ncbi.nlm.nih.gov/pubmed/27555998
http://dx.doi.org/10.1055/s-0035-1570086
Descripción
Sumario:STUDY DESIGN:  Prospective study. OBJECTIVE:  Because single-level disk arthroplasty or arthrodesis in the lower subaxial spine improves headaches after surgery, we studied whether this effect may be better appreciated after two-level arthroplasty. METHODS:  We performed an independent post hoc analysis of two concurrent prospective randomized investigational device exemption trials for cervical spondylosis, one for single-level treatment and the other for two adjacent-level treatments. RESULTS:  For the one-level study, baseline mean headache scores significantly improved at 60 months for both the cervical disk arthroplasty (CDA) and anterior cervical diskectomy and fusion (ACDF) groups (p < 0.0001). However, mean improvement in headache scores was not statistically different between the investigational and control groups from 6 months through 60 months. For the two-level study, baseline mean headache scores significantly improved at 60 months for both the CDA and ACDF groups (p < 0.0001). The CDA group demonstrated greater improvement from baseline at all points; this difference was statistically significant at 6, 12, 24, 36, and 48 months but not at 18 and 60 months. CONCLUSION:  Both CDA and ACDF at either one or two levels are associated with sustained headache relief from baseline. Patients undergoing two-level arthroplasty had significantly greater improvement in headache at all points except for at 18 and 60 months. This difference in improvement was not observed in patients undergoing single-level arthroplasty. The mechanism of greater headache relief after two-level arthroplasty remains unclear.